Individual
JASON BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
9171 COCKERHAM RD, DENHAM SPRINGS, LA 70726-2255
(255) 235-1242
Mailing address
9171 COCKERHAM RD, DENHAM SPRINGS, LA 70726-2255
(255) 235-1242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5595
LA
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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